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A Latent Class Analysis of Chronic Health Conditions Among HIV-Positive Transgender Women of Color

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Abstract

Research on the health of transgender people has focused on the risk for and health consequences of HIV and other sexually transmitted infections with little known about the prevalence of a broader range of medical conditions experienced by transgender people. This study used latent class (LC) analysis to examine a range of chronic medical conditions among 223 HIV-positive transgender women of color receiving primary care and psychosocial services in Chicago. The best-fitting model had 2 classes: low and moderate/high multimorbidity with 26% of participants classified in the moderate/high multimorbidity LC. Age group (i.e., under 35 vs 35 and older; AOR 13.8, p < 0.001), ever having AIDS (AOR 4.0, p < 0.05) and psychological distress (AOR 5.1, p < 0.05) were associated with increased probability of moderate/high multimorbidity class membership. The results suggest focusing on HIV-related care or hormonal treatment and potential cardiovascular issues could result in sub-optimal treatment for a population dis-engaged from primary care but which has a broad spectrum of largely untreated medical conditions.

Resumen

La investigación sobre la salud de las personas transgénero se ha centrado en el riesgo y las consecuencias del VIH y otras infecciones de transmisión sexual, y se sabe poco acerca de la prevalencia de una gama más amplia de condiciones médicas experimentadas por las personas transgénero. Este estudio utilizó un análisis de clase latente (LC) para examinar una gama de condiciones médicas crónicas entre 223 mujeres transgénero VIH positivas que reciben atención primaria y servicios psicosociales en Chicago. El modelo que mejor se ajustó tuvo 2 clases: multimorbilidad baja y moderada/alta, con 26% de los participantes clasificados en la LC de multimorbilidad moderada/alta. Grupo de edad (es decir, menores de 35 contra 35 y más; AOR = 13.8, p < 0.001), con SIDA (AOR = 4.0, p < 0.05) y angustia psicológica (AOR = 5.1, p < 0.05) fueron asociado con una mayor probabilidad de membresía de clase de multimorbilidad moderada/alta. Los resultados sugieren que centrarse en la atención relacionada con el VIH o en el tratamiento hormonal y los posibles problemas cardiovasculares podrían resultar en un tratamiento subóptimo para una población que participa muy poco en la atención primaria, pero que tiene un amplio espectro de condiciones médicas en gran parte no tratadas.

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Acknowledgements

This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Grant Numbers H97HA24969 and H97HA24965 awarded to Howard Brown Health Center and Chicago House respectively. No percentage of this project was financed with non-governmental sources. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

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Authors and Affiliations

  1. Jane Addams College of Social Work, University of Illinois at Chicago, 1040 W. Harrison Street, (M/C 309), Chicago, IL, 60607, USA

    James A. Swartz

  2. Howard Brown Health, Chicago, IL, USA

    Kelly Ducheny, Trisha Holloway, Lia Stokes & Savannah Willis

  3. Division of Adolescent Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Lisa M. Kuhns

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  1. James A. Swartz
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Correspondence to James A. Swartz.

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Swartz, J.A., Ducheny, K., Holloway, T. et al. A Latent Class Analysis of Chronic Health Conditions Among HIV-Positive Transgender Women of Color. AIDS Behav 25 (Suppl 1), 52–63 (2021). https://doi.org/10.1007/s10461-019-02543-3

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